Abdominal bloating
What's a bloated belly?
A bloated belly is a feeling of fullness, pressure or tension in the abdomen. Sometimes the belly is visible, but it doesn't have to be. The symptoms can occur especially after eating, increase during the day or are almost constantly present. Also, flatulence, belching, abdominal pain, nausea, rapid feeling full or changes in stool may occur.
A bloated belly can develop temporarily after a large or hard to digest meal, but also regularly return without obvious cause. In case of long-term complaints, Chinese medicine not only looks at the bloating itself, but also at your digestion, stool, nutrition, energy level and the influence of stress, for example.
Possible Western disorders
A bloated abdomen is a symptom and not a separate condition. It may occur in:
- irritable bowel syndrome (PDS);
- constipation;
- functional dyspepsia;
- food intolerances, such as lactose intolerance;
- coeliac disease;
- gastrooesophageal reflux (GERD);
- gastrointestinal infections.
Eating habits can also play an important role. Large meals, fast food and foods that cause a lot of gas formation in you can increase the symptoms, for example.
A new, persistent or strongly increasing bloating abdomen deserves medical assessment, especially when associated with unexplained weight loss, stool blood, persistent vomiting, fever, severe abdominal pain or a marked change in stool pattern.
Possible causes
Bloating may occur when more gas, fluid or intestinal contents are present in the gastrointestinal tract, but the experienced bloating does not always have to correspond to the amount of gas in the gut.
Food and eating habits often play a role. Large meals, over-eating or food that is difficult to digest can cause a temporary full and tense feeling. Constipation can also contribute because intestinal content accumulates.
In addition, the movement and sensitivity of stomach and intestines can play a role. In some people stress is a clear triggering factor. The abdomen can then set up much stronger during busy or emotionally burdensome periods.
What can acupuncture do?
Acupuncture looks at the way in which the bloating occurs in you. Is it especially after eating? Does the belly become hard and tense or especially full and heavy? Does belching or flatulence relieve? And are there also complaints such as constipation, diarrhoea, nausea, fatigue or stress?
On this basis, treatment may include:
- improve the movement of Qi in the digestive system, which can reduce fullness and tension
- strengthen the Spleen and Stomach when digestion is weakened
- Reduce food stagnation when food is not sufficiently processed and continues to hang on
- Dampness or Phlegm reduce when moisture and nourishment are not properly processed according to TCM
- Dampness-Heat reduce when, in addition to accumulation, signs of heat and irritation are present
- reduce the effect of stress on digestion when stress is clearly involved
Which treatment principles are combined depends on the underlying TCM pattern. Therefore, not everyone with a bloated abdomen receives the same treatment.
What can Chinese herbal medicine do?
Chinese herbs are also tuned to the cause of the bloating and other complaints that are present. In someone who gets blown up and tired especially after eating, for example, treatment may be needed other than in someone with a hard, tense abdomen, a lot of flatulence and constipation.
Depending on the pattern, herbal treatment may focus on:
- regulate the movement of Qi in a tense and bloated abdomen
- support the Spleen and Stomach in weak digestion
- helping to process accumulated food in food stagnation
- Dampness and Phlegm reduce when feeling heavy, full or nausea
- Reduce Dampness-Heat when accumulation coincides with heat
- heating digestion when Cold and a shortage of Yang are in the foreground
Acupuncture and herbs work in their own way, but are based on the same pattern recognition and can complement each other. Herbs can be used daily between treatments and adjusted during the treatment process.
How does Chinese medicine view abdominal bloating?
Within Chinese medicine, good digestion depends on a smooth processing and movement of food and moisture. Especially the Spleen and Stomach play an important role in this.
The Stomach receives food and should move down the contents of the digestive system. The Spleen stands within TCM for further processing of nutrition and moisture and making nutrients and Qi available.
In a bloated belly there is often a disturbance of this normal movement. This is called Qi dynamics. If Qi does not move properly, a feeling of pressure, tension or blockage can arise. This can happen for example by stuck Qi, food stagnation, Dampness or Phlegm. However, the same movement may also become disturbed because the digestion is too weak.
The Liver can also be involved. Within TCM, the Liver supports Qi's free movement. If this movement stagnates due to stress or emotional tension, it can disturb the Spleen and Stomach. The bloating can then vary greatly and clearly associated with tension.
In case of long-term complaints, different processes can also affect each other. For example, a weak Spleen can cause Dampness, while prolonged stagnation can develop Heat. This causes multiple patterns to occur at the same time.
A recognizable combination of symptoms and symptoms is called a TCM pattern. Below, only the most common patterns are discussed. Other patterns are possible and multiple patterns can occur at the same time. This allows you to recognize yourself in multiple descriptions. Also, not everyone with the same pattern has all the mentioned symptoms. The pattern is determined based on the overall picture of complaints.
What is a TCM organ system?
A TCM organ system includes more than just the anatomical organ. It describes a coherent set of physical functions and processes. Read more about this at TCM basics .
What is a TCM pattern?
A TCM pattern is a recognizable combination of signs and symptoms that indicates what disruption according to Chinese medicine is at the forefront. Read more about this at TCM basics .
Most common TCM patterns
Liver-Qi-stagnation
Brief explanation
With Liver-Qi stagnation, the movement of Qi is not smooth. As a result, tension can fasten in the abdomen. The bloating can vary greatly and is often clearly related to stress, frustration or other emotional factors.
Common symptoms: a tense or bloated belly, lots of belching or flatulence where letting air escape gives some relief, pressure or tension around the stomach and ribs, varying stools and complaints that increase during stress. Irritability or tenseness may also occur.
Examples of Western disorders: PDS, functional dyspepsia and reflux symptoms.
Food stagnation
Brief explanation
In case of food stagnation there is temporarily more nutrition than the digestion can handle properly. This may occur after over-eating or heavy meals, but in case of weakened digestion normal amounts may also cause problems.
Common symptoms: clear fullness and bloating after eating, low appetite, belching with a food smell, strong smelling flatulence, nausea, reflux and constipation or irregular stools. The abdomen may feel tense and pressure is often unpleasant.
Examples of Western disorders: functional dyspepsia, reflux symptoms and temporary indigestion after excessive or heavy eating.
Damp-Heat
Brief explanation
At Dampness-Heat, according to TCM there is both accumulation and Heat in the digestive system. This can create a fairly persistent and clearly uncomfortable feeling of fullness.
Common symptoms: persistent or severe bloating, a tense or firm abdominal pain, nausea, low appetite, feeling heavy in the body, bitter or unpleasant taste, thirst without much to drink and concentrated urine. Both thin and difficult stools can occur.
Examples of Western disorders: gastroenteritis and various gastrointestinal symptoms that prevent diarrhoea, nausea or inflammatory symptoms.
Phlegm-Dampness
Brief explanation
At Phlegm-Dampness, nutrition and body fluids are not sufficiently processed according to TCM, resulting in a heavier form of accumulation. This pattern often coincides with a weaker Spleen function.
Common symptoms: persistent and sometimes severe bloating, heavy or full feeling, belching, reflux, morning nausea, decreased appetite, heavy or blurred head and sometimes mucus formation from nose or airways. The symptoms may increase after fat, heavy or sweet eating.
Examples of Western disorders: PDS, functional dyspepsia, chronic gastritis and other long-term functional gastrointestinal symptoms.
Spleen- and Stomach-Qi-deficiency
Brief explanation
With this pattern, the digestion according to TCM is not strong enough to process food and moisture properly. As a result, the bloating is not caused by a strong blockage, but by the weakening of normal movement and processing.
Common symptoms: a bloated belly that occurs or gets worse especially after eating, low appetite, quickly full up, tiredness after meals, soft or thin stools and a general feeling of weakness. The abdomen usually feels soft rather than hard and tense.
Examples of Western disorders: PDS, functional dyspepsia, chronic diarrhoea and other long-term functional digestive symptoms.
Spleen- and Stomach-Yang-deficiency
Brief explanation
This is a further form of weakened digestion. Besides insufficient Qi, according to TCM there is also too little heating force, which reduces the efficiency of food and moisture processing.
Common symptoms: chronic bloating, a soft or cold belly, thin or watery stools, fatigue, crookedness and cold hands and feet. Abdominal pain or discomfort can be improved by heat and pressure.
Examples of Western disorders: chronic diarrhoea, some forms of PDS and long-term functional gastrointestinal symptoms.
Stomach-Yin-deficiency
Brief explanation
Within TCM, Yin stands for the nourishing and moistening aspects of the body. At Stomach-Yin deficiency these are not sufficiently present in the Stomach. This pattern usually arises with long-term complaints and gives more dryness and mild heat than moisture accumulation.
Common symptoms: chronic fullness or distension in the upper abdomen, a difficult to describe stomach sensation, dry mouth, low appetite or hunger but do not want to eat, dry stools and sometimes heartburn.
Examples of Western disorders: chronic or atrophic gastritis, reflux symptoms and functional dyspepsia.
Outlook
The course of treatment depends on the cause, duration and severity of the symptoms. A bloated abdomen that has recently been created by diet or temporary digestive disruption can improve relatively quickly. For long-term complaints, for example with PDS or when a clear Qi, Yang or Yin deficiency is present, more time is usually needed.
In the initial phase acupuncture is a common guideline once a week. In the event of persistent complaints, it can temporarily be appropriate twice a week. As the symptoms decrease and remain more stable, the frequency can be reduced. When Chinese herbs are used, they can be taken daily and adjusted during the treatment course.
Food and eating habits often play an important role in a bloated stomach. Therefore, it also looks at meal size, regularity and foods that clearly affect your symptoms.
Contact
Do you have frequent bloating and want to know if acupuncture and/or Chinese herbal medicine can fit your symptoms? During a first consultation we discuss not only the bloating, but also your digestion, stool, nutrition and other relevant complaints. On this basis, we will examine which TCM pattern suits your situation best and what treatment fits it.